HB 22-1284: Surprise Billing Protections Summary

• Aligns Colorado state surprise billing laws with the federal "No Surprises Act" (Pub.L. 116-260) to protect consumers from unexpected out-of-network charges

• Requires carriers to cover emergency services and certain post-stabilization services at in-network benefit levels regardless of provider network status, with payments applied to in-network deductibles and out-of-pocket maximums

• Prohibits balance billing for ancillary services (diagnostic, emergency-related, surgical support services) and requires written notice with 72 hours advance warning (or 3 hours if scheduled within 72 hours) before balance billing for other services

• Establishes independent external review process for determining whether surprise billing protections apply and creates a work group to streamline implementation and address payment disputes

• Appropriates $233,018 for fiscal year 2022-23 to the Department of Regulatory Agencies (1.6 FTE for insurance division), Department of Law (0.5 FTE), and Department of Public Health and Environment (0.1 FTE) for implementation